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DR. SUNIL RAJ THOMAS M.D.
NPI 1427362698
Internal Medicine - Endocrinology, Diabetes & Metabolism in North Haven, CT

Active since July 30, 2010PECOS EnrolledAccepts Medicare Assignment
84.47/100
CMS Quality Rating
190 UNIVERSAL DRIVE, SUITE 103, NORTH HAVEN, CT 06473(203) 234-5980(203) 239-1028 Get Directions Write a Review

NPPES record last updated: November 14, 2022. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: Nov 14, 2022, Apr 30, 2021, Jan 31, 2017 and 3 more (6 updates tracked since 2016).

About Dr. Sunil Raj Thomas M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

DR. SUNIL RAJ THOMAS M.D. (NPI 1427362698) is an individual endocrinology, diabetes & metabolism provider in North Haven, Connecticut, licensed in Connecticut (72367) and active in the NPI registry since July 2010. He is enrolled in Medicare PECOS and is a graduate of Other (1997).

NPPES Registry Identity

NPI1427362698
Entity TypeIndividualMale
Primary Taxonomy207RE0101X
Provider Legal NameDR. SUNIL RAJ THOMASCredential: M.D.
Location Address190 UNIVERSAL DRIVE, SUITE 103North Haven, CT 06473-3683
Mailing Address1290 Silas Deane Hwy, Hartford Healthcare-cvoWethersfield, CT 06109-4337
Phone(203) 234-5980
Fax(203) 239-1028
Sole ProprietorNo
Medical School CMSOtherGraduated 1997
Enumeration DateJuly 30, 2010
Last NPPES UpdateNovember 14, 20226 updates tracked since enumeration
NPPES CertifiedNovember 10, 2022
✔ NPI 1427362698 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyInternal Medicine · Endocrinology, Diabetes & MetabolismAllopathic & Osteopathic Physicians
Taxonomy Code207RE0101X
Licenses✔ Licensed in CT · 72367✔ Licensed in NJ · 25MA09787900
Definition
An internist who concentrates on disorders of the internal (endocrine) glands such as the thyroid and adrenal glands. This specialist also deals with disorders such as diabetes, metabolic and nutritional disorders, obesity, pituitary diseases and menstrual and sexual problems.
Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X
190 UNIVERSAL DRIVE, North Haven, CT 06473
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Dr. Sunil Raj Thomas M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID4082837091
PECOS Enrollment IDI20221114000564
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Sunil Thomas reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Hartford Healthcare Medical Group Specialists, PLLC
30 mi
Surgery
85 SEYMOUR ST STE 415
Hartford, CT 06106
  • Reassigned Medicare billing, Connecticut enrollment
  • 1,921 clinicians in this Medicare group
NPI 1023584216 (860) 246-2071

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 3

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214
This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.
119 services74 patients
New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204
This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.
60 services60 patients
Hemoglobin a1c level 83036
Hemoglobin A1c (HbA1c) is a test that measures your average blood sugar level over the past 2-3 months. It's used to monitor how well diabetes is being controlled. High levels may indicate that your diabetes treatment plan needs adjustment.
19 services18 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 06473 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$138.84 typical visit price
range $60.82 – $183.10
Typical copayment $34.71 (range $15.20 – $45.77)
Most-billed visit code 99204
Established Patient
$106.68 typical visit price
range $19.76 – $149.26
Typical copayment $26.67 (range $4.94 – $37.31)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

84.47/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality79.28
Promoting Interoperability100
Improvement Activities40
Cost59.59

Reported Quality Measures

Documentation of Current Medications in the Medical Record
Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.
100%1,984 patients5/55-star benchmark: 100%
e-Prescribing
At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.
96%3,661 patients4/55-star benchmark: 99%
Falls: Screening for Future Fall Risk
Percentage of patients 65 years of age and older who were screened for future fall risk during the measurement period
98%330 patients4/55-star benchmark: 99%
Medication Reconciliation
The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.
98%188 patients4/55-star benchmark: 100%
Patient-Specific Education
The MIPS eligible clinician must use clinically relevant information from CEHRT to identify patient-specific educational resources and provide access to those materials to at least one unique patient seen by the MIPS eligible clinician.
53%1,134 patients3/55-star benchmark: 97%
Preventive Care and Screening: Body Mass Index (BMI) Screening and Follow-Up Plan
Percentage of patients aged 18 years and older with a BMI documented during the current encounter or during the previous twelve months AND with a BMI outside of normal parameters, a follow-up plan is documented during the encounter or during the previous…
55%1,101 patients3/55-star benchmark: 97%
Preventive Care and Screening: Tobacco Use: Screening and Cessation Intervention
Percentage of patients aged 18 years and older who were screened for tobacco use one or more times within 24 months AND who received tobacco cessation intervention if identified as a tobacco user
Patients screenedForUse: 99% · 640 patients
Patients tobacco: 13% · 45 patients
91%640 patients4/55-star benchmark: 98%
Provide Patient Access
At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…
93%1,134 patients4/55-star benchmark: 100%
Secure Messaging
For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…
33%1,134 patients2/55-star benchmark: 89%
View, Download, or Transmit (VDT)
At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.
42%1,134 patients
Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Referred Medical Equipment & Supplies CMS DME claims 3

Durable medical equipment, devices and supplies this provider ordered from DME suppliers for patients, from Medicare fee-for-service claims.

Blood glucose test or reagent strips for home blood glucose monitor, per 50 strips A4253
DME-Other DME · category DE017N
38 suppliers108 claims372 services$6.09 avg. paid by Medicare
Lancets, per box of 100 A4259
DME-Medical/Surgical Supplies · category DA000N
19 suppliers37 claims68 services$1.06 avg. paid by Medicare
Supply allowance for therapeutic continuous glucose monitor (cgm), includes all supplies and accessories, 1 month supply = 1 unit of service K0553
DME-Other DME · category DE017N
7 suppliers116 claims120 services$186.85 avg. paid by Medicare
Dollar amounts are the average Medicare paid the supplier per service. They are not the cost to the patient.

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

CASSANDRA MARIE MUXEN MD
Internal Medicine
190 UNIVERSAL DRIVE
NORTH HAVEN, CT 06473
South Central Connecticut Planning Region (203) 694-7550

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Sunil Thomas's NPI number?

The NPI number for Sunil Thomas is 1427362698. It was assigned to this individual provider in the NPPES registry on July 30, 2010.

Where is Sunil Thomas located?

Sunil Thomas practices at 190 Universal Drive Suite 103, North Haven, CT 06473. The listed phone number is (203) 234-5980.

What is Sunil Thomas's specialty?

The primary specialty registered for this NPI is Internal Medicine, specializing in Endocrinology, Diabetes & Metabolism, with taxonomy code 207RE0101X.

Is Sunil Thomas enrolled in Medicare?

Yes. Sunil Thomas is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organization bills Medicare for Sunil Thomas's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Sunil Thomas reassigns Medicare benefits to Hartford Healthcare Medical Group Specialists, PLLC (Hartford, CT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Sunil Thomas's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Sunil Thomas accept?

Health plans from Anthem Blue Cross and Blue Shield list Sunil Thomas as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Sunil Thomas was last updated on November 14, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 3 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.